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Parkinson’s Disease
Volume 2010, Article ID 201089, 7 pages
Research Article

Parkinsonian Symptomatology May Correlate with CT Findings before and after Shunting in Idiopathic Normal Pressure Hydrocephalus

1Department of Rehabilitation Science, Kobe University Graduate School of Health Sciences, Kobe 654-0142, Japan
2Department of Physical Therapy, Bukkyo University School of Health Science, Kyoto 603-8301, Japan
3Center of Neurological and Cerebrovascular Disease, Koseikai Takeda Hospital, Kyoto 600-8558, Japan
4Department of Physical Therapy, Maizuru Municipal Hospital, Kyoto 625-0035, Japan

Received 30 September 2009; Revised 28 December 2009; Accepted 23 January 2010

Academic Editor: Hélio Teive

Copyright © 2010 Mitsuaki Ishii et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


We aimed to investigate the characteristics of Parkinsonian features assessed by the unified Parkinson's disease rating scale (UPDRS) and determine their correlations with the computed tomography (CT) findings in patients with idiopathic normal pressure hydrocephalus (iNPH). The total score and the scores for arising from chair, gait, postural stability, and body hypokinesia in the motor examination section of UPDRS were significantly improved after shunt operations. Stepwise multiple regression analysis revealed that postural stability was the determinant of the gait domain score of the iNPH grading scale. The canonical correlation analysis between the CT findings and the shunt-responsive Parkinsonian features indicated that Evans index rather than midbrain diameters had a large influence on the postural stability. Thus, the pathophysiology of postural instability as a cardinal feature of gait disturbance may be associated with impaired frontal projections close to the frontal horns of the lateral ventricles in the iNPH patients.